The following forms may be used, but are not required, to request inspection or copies of public records and to respond to public records requests, respectively:

1. (1) Public Records Request Form: (This space intentionally left blank) PUBLIC RECORDS REQUEST FORM The Tennessee Public Records Act (TPRA) grants Tennessee citizens the right to access open public records that exist at the time of the request. The TPRA does not require records custodians to compile information or create or recreate records that do not exist. To: Public Records Request Coordinator Office of General Counsel Tennessee Department of Transportation 3rd Floor, James K. Polk Building 505 Deaderick Street Nashville, Tennessee 37243 From: _____________________________________ _____________________________________ _____________________________________ Is the requestor a Tennessee citizen? ____ Yes _____ No Request: ____ Inspection ____ Copy/Duplicate If costs for copies are assessed, the requestor will receive an estimate. Delivery will be made by first class mail unless the requestor specifies otherwise. Records Requested: Provide a detailed description of the record(s) requested, including type of record(s), timeframe or dates for the record(s) sought, and subject matter or key words related to the record(s). Under the TPRA, record requests must be sufficiently detailed to enable a governmental entity to identify the specific records sought. As such, your request must provide enough detail to enable the records custodian responding to the request to identify the specific records you are seeking. _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________ ________________________________ Signature of Requestor and Date Signature of PRRC and Date
2. (2) Public Records Request Response Form: PUBLIC RECORDS REQUEST RESPONSE FORM Office of General Counsel Tennessee Department of Transportation 3rd Floor, James K. Polk Building 505 Deaderick Street Nashville, Tennessee 37243 [Date] [Requestor’s Name and Contact Information]: In response to your public records request received on __________, our office is taking the action(s) as indicated below: □ The public records responsive to your request will be made available for inspection: Location:________________________ Date/Time:______________________________ □ Copies of public records responsive to your request are: □ Attached □ Available for pickup at the following location: _________________________________ □ Being delivered via U.S. Mail or other method:________________________________ □ Your request is being denied on the following grounds: □ Your request was not sufficiently detailed to enable identification of the specific requested records. You need to provide additional information to identify the records. □ No such records exist or this office does not maintain records responsive to your request. □ No proof of TN citizenship was presented with your request (if required). Your request will be reconsidered upon presentation of an adequate form of identification. □ You are not a Tennessee citizen (if required). □ You have not paid the copying/production fees. □ The following state, federal, or other applicable law prohibits disclosure of the requested records: _____________________________________. □ It is not practicable for the records you requested to be made promptly available for inspection and/or copying because: □ It has not yet been determined that records responsive to your request exist; or □ TDOT is still in the process of retrieving, reviewing and/or redacting the requested records. The time reasonable necessary to produce the records or information and/or to make a determination of a proper response to your request is: ______________________________________________________. If you have any additional questions regarding your record request please contact: _____________________________. Sincerely, [Records Custodian or PRRC/Name and Contact Information]

Authority: T.C.A. §§ 4-3-2303(2), 10-7-503, and 10-7-506. Administrative History: Original rule filed November 6, 2018; effective February 4, 2019.